When is your appointment?

MM

DD

YYYY

Name *

First Name

Last Name

Phone

(###)

###

####

Do you have any allergies to hair color? *

Yes

No

Do you use Permanent, Demi or Temporary color? *

Note: Demi-Permanent color last up to 25 shampoos. Temporary last up to 8 shampoos.

Permanent

Demi-Permanent

Temporary

What type of hair color do you currently have? *

All-over color

Root color and highlights

Highlights only

Balayage

All-over lightening bleach

Henna

Creative color

Corrective color

None, my color is natural

When was the last time you colored your hair? *

Less than 1 month

1-3 months

3-6 months

Over 6 months

Where do you normally color your hair? *

At home

Salon

Both

What other hair treatments have you had in the last 6 months *

Note: Chemical treatments such as perms and relaxers can affect how your hair takes color. This information helps us determine the best formulation to achieve your desired look and to avoid unexpected results.

Keratin

Relaxer / Straightener

Hair color remover

Perm

None

Other

What is your natural hair color?

Lightest to dark blonde

Light brown to Black

Copper & Reds

How long is your hair? *

Very short (above the ears)

Short (to the chin)

Shoulder length (pass chin, above shoulders)

Long (to the shoulders)

Very long (pass the shoulders)

How much gray do you have? *

None

Few

Lots

All

How straight or curly is your hair? *

Straight

Wavy/loose curls

Defined curls

Tight curls

How thick is your hair? *

Note: Your hair's circumference - or thickness - can affect how resistant to color it is. This information helps us determine your specific formula and processing time.

Fine

Normal

Thick

What is your ethnicity? (Optional)

Asian

Latin

Caucasian

African American

Native American

Other

What color are your eyes? (Optional)

Amber

Blue

Brown

Gray

Green

Hazel